The condition, chronic rhinosinusitis (or persistent blocked nose) affects 11% of Americans. Recent research has shown a link between the condition, and brain activity changes.
The study's team hopes that the link will explain other effects of persistent inflammation, such as difficulty focusing, depression and trouble sleeping.
It could be crucial to establish a link between the underlying condition and neural processing occurring elsewhere. This would help in understanding the chronic condition and helping to develop better and more effective treatments.
Aria Jafari, an otolaryngologist at the University of Washington, stated that "this is the first study to link chronic sinus inflammation with neurobiological changes". The paper was published in April 2021.
We know from past studies that sinusitis patients often seek medical attention not because of their runny noses or high sinus pressure but because it is affecting their ability to interact with the outside world. They are unable to be productive, their thinking is difficult and their sleep quality is poor. It has a profound impact on their quality of living. We now have a potential mechanism to observe clinically.
Researchers used data from the Human Connectome Project in order to identify 22 people with chronic rhinosinusitis, and 22 healthy controls without any sinus inflammation. The data from fMRI scans was then used to assess blood flow and brain activity.
Researchers found lower functional connectivity among sinus inflammation patients. They also observed lower functional connectivity within the frontoparietal (used for attention, problem solving, and self-reference), higher functional connectivity with the default mode network (used to manage external stimuli, communication, and social behavior), and lower connectivity in salience network (used to link to mind wandering and self-reference).
The team found that the differences were more noticeable in patients with severe rhinosinusitis. These symptoms could all be caused by increased or decreased brain activity.
The cognitive tests showed no signs of cognitive decline in the 22 subjects with chronic sinusitis. The researchers believe that this type of decline could occur later in life, something that a longitudinal study may be able detect.
Kristina Simonyan from Harvard University said that sinus inflammation can cause subjective symptoms such as attention loss, difficulty focusing, or sleep disturbances.
Current treatments for rhinosinusitis may last many years. The severity of the condition can change over time and the sinus tissue can thicken (like calloused or irritated skin). Although surgery may be an option, there is no guarantee that the symptoms will not recur.
Although the new research does not prove that chronic sinus inflammation causes brain activity changes, it is enough to warrant further investigation. Future studies could examine how brain activity changes after treatment for chronic rhinosinusitis patients, for instance.
The researchers suggest that doctors should be more aware of mental health symptoms associated with diseases such as the sinus inflammation that was studied here. They also need to be aware of how these symptoms might manifest in other parts of the body.
Jafari stated, "Our care should not be restricted to relieving the most obvious physical symptoms but the entire burden of patients' diseases."
The research was published in JAMA Otolaryngology -Head & Neck Surgery.
This article was first published in April 2021.